How much rates vary
Facilitymedian $182 · 10th to 90th $107 to $2,399Professionalmedian $148 · 10th to 90th $76 to $275
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $134.90 | Professional | None | $64.57 | $87.10 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $660.69 | Facility | None | $95.50 | $123.03 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $288.40 | Professional | None | $93.33 | $154.88 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $251.19 | Professional | None | $109.65 | $165.96 | $251.19 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $186.21 Typical High $6,606.93 | Facility | None | $107.15 | $186.21 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $218.78 | Professional | None | $72.44 | $120.23 | $218.78 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $204.17 | Facility | None | $112.20 | $169.82 | $204.17 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $134.90 Typical High $707.95 | Facility | None | $95.50 | $134.90 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $275.42 | Professional | None | $79.43 | $154.88 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $3,235.94 | Facility | None | $1,905.46 | $2,691.53 | $3,235.94 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $275.42 | Professional | None | $125.89 | $199.53 | $275.42 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $295.12 | Professional | None | $107.15 | $169.82 | $295.12 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $42.66 Typical High $60.26 | Professional | 52 · Reduced service | $38.02 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.98 Typical High $23.99 | Professional | 53 · Discontinued | $15.14 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $64.57 Typical High $91.20 | Professional | 54 · Surgery only | $56.23 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $18.20 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.59 | $8.51 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $60.26 | Professional | 52 · Reduced service | $38.02 | $38.02 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $23.99 | Professional | 53 · Discontinued | $15.14 | $15.14 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $91.20 | Professional | 54 · Surgery only | $56.23 | $56.23 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $18.20 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $12.02 |
Where Oregon sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 6th of 51
$166
WI $282KY $77.62
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.